Grateful to the Dead

Tijuana anatomy professor: My students learn compassion.

"Doctors, dentists, surgeons don’t have to guess about what they’re doing. Where to cut. How to cut. How to suture. All that knowledge comes from human dissection, from studying the bodies of the dead."

Not long after my brother died and was buried in Oregon, I found myself in the depósito de cadáveres, or morgue, at Tijuana’s Autonomous University of Baja California. My hand rested on the handle of a large walk-in refrigerator. I wasn’t sure what I’d see inside.

Earlier in the day I attended a one-hour lecture given by Dr. Luis Antonio Martínez, a dental surgeon who teaches anatomy to students at the university’s dentistry school. His lecture was attended by 20 first-year students, of whom only 2 were male. Dr. Martínez was preparing his students for their first cadaver dissection. On the blackboard he drew a simple human face — ears, eyes, nose, mouth, chin.

“Next week you will first make a straight, horizontal, seven-centimeter incision two centimeters below the lip.”

The students, all in their early 20s, copied Dr. Martínez’s drawing of a face and his instructions into their notebooks. Dr. Martínez described how the students were to make three shallow incisions into the cadaver’s chin.

“Then you will take the top left corner of this trapezoid in your clamps and, inserting your scalpel at a 45-degree angle into the incision, begin carefully to cut, separating the skin from the tissue beneath.

“As you cut and pull away the skin, you will first see fat, which is yellow. You may also see muscle tissue, which, depending on the freshness of the cadaver, will be either deep pink or light brown.”

The young woman sitting next to me shuddered but didn’t look up. She wrote in her notebook “muscle tissue, deep pink, light brown.” Her fingernails were painted glittery red.

Dr. Martínez went on to describe three muscles his students would reveal beneath the skin and fat.

“And at the end of the dissection, I will show you why dissection is important. I will show you the precise points you will need to inject in order to anesthetize either the right or left front corner of the mouth. You’re going to see exactly where these points are, between the first and second bicuspid. When you work with patients, you won’t be able to see these points beneath the tissue. You will have to visualize them in your mind. By dissection, you will have a clear picture of where they are.”

Dr. Martínez, in khakis and pressed white shirt, his complexion fair, his skin unwrinkled, his thick dark hair combed straight back, didn’t look much older than the students he lectured. He is a 33-year-old father of three who, in addition to lecturing at the university two days each week, owns and runs two dental clinics. On a busy day like a Saturday, each of his clinics may see as many as 20 patients.

“I don’t have to teach,” Dr. Martínez told me. “But I love to teach. I like being around young people, their energy. When you’re my students’ age, you have everything to look forward to. You have all these dreams for your future. You get older, things change. Not long ago I was thinking about this, and I realized, ‘Hey, that future I used to dream about when I was young — I’m living that future now!’ ”

Dr. Martínez has been teaching anatomy at the university since he was 26 years old.

“You may notice that there are very few boys in my class. In Mexico, boys want to be doctors, not dentists. Boys have this idea that dentistry is delicate work, feminine work. It’s an entirely wrong idea. But I was like that. When I first went to university, I wanted to be a doctor. I had almost completed my first year of medical school when my grandmother was diagnosed with uterine cancer. My father wanted to do whatever was necessary to help her. He told me, ‘Son, the next year or so is going to be financially difficult for our family. I’m afraid you’re going to have to quit school for a while and get a job.’

“I went to San Diego and got a job as a waiter at Anthony’s. I loved it. On a good night, I could make $100 in tips. And they had jazz. That’s where I learned to love jazz. But my poor grandmother. The family spent over $120,000 on getting her the best medical care, on making sure she stayed in the best hospitals. But in the end, no matter how hard we tried, nothing could save her.

“When I went back to school, it was too late to enroll in the medical school’s second-year program. I would have had to wait another year. Professors on the dentistry school faculty said, ‘Come on! Study with us! You can start right away.’ I enrolled in the dentistry school, and I loved it immediately. I especially loved being able to continue the study of human anatomy.

“Even when I was a child, I was fascinated with the human body. I remember I saw the movie Frankenstein, and it was just amazing. The idea of a human body having different working parts, like a machine. I wondered how the body worked. I wanted to know how it was put together.

“From the very first time I participated in dissecting a cadaver, in the year I spent in medical school, I was overwhelmed by what a tremendous privilege it was to be able to examine the human body and learn in a very precise, detailed way how it worked. It’s really an honor to have that opportunity.

“When I finished dentistry school, I had done so well in anatomy that my professors asked me to take an additional two-year course of study in the subject so I’d be able to teach it. They felt that students of general dentistry, and not just dental surgeons, should have the opportunity to do dissection. So, anatomy is all I did for two years. Anatomy and dissection. And then I started to teach, which was a little strange because I was only a few years older than many of my students. I had to work hard to gain their respect. I had to show them, in a careful, thoughtful way, that I knew what I was talking about, that I was competent.”